肝圆韧带在胃十二指肠溃疡穿孔修补术中的应用

Application of hepatic round ligament in repair of gastroduodenal ulcer perforation

目的 :探寻一种大网膜以外的其它自体材料进行上消化道溃疡穿孔的修补方法。方法 :将肝圆韧带在靠近脐部切断、结扎 ,紧贴前腹壁游离近肝侧至肝纵裂处与肝脏附着 ,再将肝圆韧带游离端覆盖在穿孔处 ,按常规方法缝合修补。结果 :本组 1 2例 ,全部治愈 ,手术时间 45— 1 1 0分钟 ,平均5 6分钟 ,无手术死亡 ,无胃瘘 ,腹腔脓肿、切口感染等并发病 ,结论 :用该方法修补 ,效果满意 ,取材方便 ,距病灶近 ,韧性好、血运佳、不易坏死 ,易于粘连封闭穿孔处 ,不失为一种简单、有效、安全的方法 ,可以作为大网膜不能利用等特殊情况下的一种补充方法。

Objective:Search a method to repair gastroduodenal ulcer perforation using auto-material other than greater omentum.Methods:Cut off hepatic round ligament,ligate,and attach to liver.Cover the perforation with the fee and of the ligament and then suture and repair as routine.Results:All 12 cass were cured.Duration of operation was 45-110 min.The average was 45 min.No death,no gastric fistula.no abdominal abscess.no incision infection or other complications.Conclusion:This method is satisfying,convenient,close to focus,flexible,with good blood circulation,not easy to mecrotize,and easy to close and seal perforation.It is a simple,effective and safe method,and can be used when greater omentum can not be used and in other unusual situations.